Global Public Health Unit, School of Social & Political Science, University of Edinburgh, Edinburgh EH8 9LD, Scotland, UK.
Centre for Population Health Sciences, Usher Institute, Medical School, University of Edinburgh, Edinburgh EH8 9AG, Scotland, UK.
Soc Sci Med. 2017 Sep;189:35-43. doi: 10.1016/j.socscimed.2017.07.014. Epub 2017 Jul 21.
The role of 'advocacy' within public health attracts considerable debate but is rarely the subject of empirical research. This paper reviews the available literature and presents data from qualitative research (interviews and focus groups conducted in the UK in 2011-2013) involving 147 professionals (working in academia, the public sector, the third sector and policy settings) concerned with public health in the UK. It seeks to address the following questions: (i) What is public health advocacy and how does it relate to research?; (ii) What role (if any) do professionals concerned with public health feel researchers ought to play in advocacy?; and (iii) For those researchers who do engage in advocacy, what are the risks and challenges and to what extent can these be managed/mitigated? In answering these questions, we argue that two deeply contrasting conceptualisations of 'advocacy' exist within public health, the most dominant of which ('representational') centres on strategies for 'selling' public health goals to decision-makers and the wider public. This contrasts with an alternative (less widely employed) conceptualisation of advocacy as 'facilitational'. This approach focuses on working with communities whose voices are often unheard/ignored in policy to enable their views to contribute to debates. We argue that these divergent ways of thinking about advocacy speak to a more fundamental challenge regarding the role of the public in research, policy and practice and the activities that connect these various strands of public health research.
倡导在公共卫生中的作用引起了相当大的争议，但很少成为实证研究的主题。本文回顾了现有文献，并介绍了来自定性研究（2011-2013 年在英国进行的访谈和焦点小组）的数据，涉及 147 名专业人员（在学术界、公共部门、第三部门和政策环境中工作），他们关注英国的公共卫生。本文试图回答以下问题：(i) 什么是公共卫生倡导，它与研究有什么关系？；(ii) 关注公共卫生的专业人员认为研究人员应该在倡导中发挥什么作用（如果有的话）？；以及 (iii) 对于那些确实参与倡导的研究人员来说，存在哪些风险和挑战，以及在多大程度上可以管理/减轻这些风险和挑战？在回答这些问题时，我们认为，倡导在公共卫生中有两种截然不同的概念化，其中最主要的概念化（代表性）集中在向决策者和更广泛的公众“推销”公共卫生目标的策略上。这与倡导的另一种（使用较少）概念化形成对比，即倡导作为“促进”。这种方法侧重于与那些在政策中往往被忽视/忽视的社区合作，使他们的观点能够为辩论做出贡献。我们认为，这些关于倡导的不同思维方式反映了关于公众在研究、政策和实践中的作用以及将这些公共卫生研究的各个方面联系起来的活动的更根本挑战。
